Nursing Job Evaluation Standard

Amendments

Table of Contents

• Introduction
• Organization of the Standard
• Group Definition
• Hospital Nursing (HOS) Sub-group
• Community Health Nursing (CHN) Sub-group
• Medical Adjudicator Nursing (EMA) Sub-group
• Factors for the HOS and CHN Sub-groups
  • Professional Complexity and Responsibility Factor
  • Responsibility for Management and Management Advisory Services Factor
  • Impact Factor
• Benchmark Position Index for the HOS and CHN Sub-groups

Introduction

This standard is to be used to establish the appropriate level of work allocated to the Health Services (SH) occupational group evaluated using the Nursing (NU) job evaluation standard effective October 6, 2023. It is a key component of the classification program and must be read in conjunction with the program’s legislative and policy context.

This standard describes the plan used to evaluate positions allocated to the NU classification of the SH group. It consists of an introduction,  and definitions of the NU classification and the Hospital Nursing, Community Health Nursing, and Medical Adjudicator Nursing subgroups.

The ultimate objective of job evaluation is the determination of the relative value of jobs in each occupational group. In 2010, the Medical Adjudicator subgroup was added to the NU job evaluation standard.

Organization of the Standard

Group Definition

The Nursing (NU) classification within the Health Services (SH) Group comprises positions that are primarily involved in the application of a comprehensive knowledge of professional specialties in the field of nursing to the physical and mental well-being of people.

Hospital Nursing (HOS) Sub-group

Community Health Nursing (CHN) Sub-group

Medical Adjudicator Nursing (EMA) Sub-group

Factors for the HOS and CHN Sub-groups

• Professional Complexity and Responsibility
• Responsibility for Management and Management Advisory Service
• Impact

Benchmark Position Index for the HOS and CHN Sub groups

In ascending order of level

• Hospital Nursing (HOS) Sub-group; Community Health Nursing (CHN) Sub-group
• Professional Complexity (PC); Responsibility for Management (RM); Impact (I)

Benchmark 1: Staff Nurse

Level NU-HOS-02

Reporting to the Head Nurse:

• Identifies the nursing needs and/or preferences of assigned clients and develops and adapts a nursing care plan. Provides direct nursing care to implement preventive, diagnostic, therapeutic and rehabilitative measures. Works in accordance with policies and procedures, approved nursing care plans and medical management. Observes clients, assesses their symptoms, response and progress and evaluates their condition. Plans and implements care, including the physical, psychological, social, cultural and spiritual aspects. Records information pertaining to patient care.
• Coordinates and evaluates the nursing care provided to an assigned number of clients. Modifies nursing practices to meet the specific needs of clients.
• Guides the nursing team on the implementation of the nursing care plan. Interprets policies and procedures to auxiliary staff. Assigns duties, provides on-the-job training, and evaluates work performance of auxiliary staff.
• Identifies the need for supplies.
• Participates in research and quality assurance projects, in-service educational programs and professional meetings, and on hospital committees.

Professional Complexity and Responsibility

Degree 2

The work requires the planning and delivery of direct nursing care, teaching health and rehabilitation practices, ensuring a safe and secure environment and the maintenance of records. Responsibility is for an assigned number of clients. Guidance and clarification concerning issues associated with direct nursing care are received from the line supervisor. Advice is given to auxiliary staff in implementation of the nursing care plan.

Responsibility for Management and Management Advisory Services

Degree 2

Plans, implements, evaluates and coordinates nursing care provided to a number of clients within a hospital unit. Assigns work to auxiliary staff and facilitates on-the-job training. Delivers nursing care according to established procedures.

Impact

Degree 2

Activities affect the treatment and rehabilitation of an assigned number of clients in a hospital unit and the understanding of health care practices by an assigned number of clients and their families. The work requires participation in quality assurance activities.

Figure 1 - Text version

This is an organizational chart illustrating the reporting relationship for Staff Nurses NU-HOS which includes:

• Assistant Head Nurse NU-HOS (2 positions)
• Ward Clerk CR
• Staff Nurse NU-HOS (5 positions)
• Nursing Orderly HS-PHS (12 positions)
• Nursing Assistant HS-PHS
• Nursing Aide HS-PHS (3 positions)

The above positions are all reporting to Head Nurse NU-HOS who ultimately reports to the Assistant Director, Nursing NU-HOS.

Benchmark 2: Assistant Head Nurse

Level NU-HOS-03

Reporting to the Head Nurse:

• Organizes and directs the activities of a nursing team. Prepares schedules of care and activities for each client. Maintains clients' records of treatment and observations. Assigns work to staff and reallocates staff in cases of emergency.
• Coordinates and evaluates the nursing care provided to clients in a unit. Works in accordance with policies and procedures, approved nursing care plans and medical management. Modifies nursing practices to meet the specific needs of clients.
• Provides direct nursing care and teaches health and rehabilitative practices to clients and their families. Participates in the establishment of individual treatment and rehabilitation plans. Observes the symptoms, reaction and progress of clients. Plans and implements care, including the physical, psychological, social, cultural and spiritual aspects. Promotes a safe and hygienic environment.
• Interprets policies and procedures to subordinate staff and ensures compliance. Provides on-the-job training and orientation. Ensures that the quality of care conforms to nursing care standards. Establishes and records facts related to incidents requiring corrective action.
• Recommends the acquisition of equipment and other resources.
• Participates in research and quality assurance projects, in-service educational programs and professional meetings and on hospital committees.

Professional Complexity and Responsibility

Degree 3

The work requires planning and delivering direct nursing care, teaching health and rehabilitation practices, ensuring a safe and secure environment and maintaining records. Responsibility is for clients in a unit. Guidance and clarification concerning issues associated with direct nursing care are received from the line supervisor. Advice is given to the nursing team on implementation of the nursing care plan.

Responsibility for Management and Management Advisory Services

Degree 2

Plans, implements, evaluates and coordinates nursing care provided to a number of clients within a hospital unit. Assigns work to the nursing team and provides on-the-job training. Delivers nursing care according to established procedures

Impact

Degree 3

Activities affect the treatment and rehabilitation of clients in a hospital unit and the understanding of health care practices by clients and their families. The work requires evaluation of the quality of care delivered to clients in one unit.

Figure 2 - Text version

This is an organizational chart illustrating the reporting relationship for Assistant Head Nurses NU-HOS which includes:

• Assistant Head Nurse NU-HOS (2 positions)
• Ward Clerk CR
• Staff Nurse NU-HOS (5 positions)
• Nursing Assistant HS-PHS
• Nursing Aide HS-PHS (3 positions)
• Nursing Orderly HS-PHS (12 positions)

The above positions are all reporting to Head Nurse NU-HOS who ultimately reports to the Assistant Director, Nursing NU-HOS.

Benchmark 3: Health Care Officer

Level NU-HOS-03

Reporting to the Manager, Health Care Services:

• Provides direct nursing care to clients to implement preventive, diagnostic, therapeutic and rehabilitative measures. Works in accordance with policies, procedures, nursing care plans and medical management. Decides on action appropriate to the resolution of health care situations requiring immediate intervention while in charge of a shift.
• Orients new staff or affiliating students to the Health Care Centre policies and procedures. Explains and interprets health care and nursing service philosophy and policy to other institutional personnel and to clients.
• Screens patients and sets priorities for initiating referrals. Arranges for the admission and discharge of patients. Provides emergency and medical treatment to inmates and provides first aid services to staff and visitors to the institution. Performs basic clinical tests according to standing Health Care Clinical Orders. Maintains records of nursing observations, health conditions and care. Teaches health promotion and disease prevention to offenders and groups of offenders. Contributes to the understanding of health practices, disease prevention and health promotion by non-health institutional personnel.
• Assists medical staff in examinations and treatments. Contributes to the organization and operation of the Institutional Physician's and allied health care workers' clinics. Participates in research and quality assurance projects, on health care committees and continuing education and professional meetings. Ensures the safety and security of the Health Care Centre and the work team.
• Requisitions supplies and equipment.

Professional Complexity and Responsibility

Degree 3

The work requires planning and delivering direct nursing care, teaching health education, ensuring a safe and secure environment and maintaining records. Responsibility is for individuals or groups of clients. In addition the work requires exercising primary decision making responsibility for health care situations requiring immediate intervention when in charge of a shift. Guidance on the methods and procedures of direct nursing care and health education program objectives is received from the line supervisor. Advice is given to the administrative support staff.

Responsibility for Management and Management Advisory Services

Degree 2

Plans, implements, evaluates and coordinates nursing care provided to a number of clients within a correctional facility. Requisitions supplies and equipment and maintains records. Delivers nursing care according to procedures and adapts techniques as necessary.

Impact

Degree 3

Activities affect the treatment and rehabilitation of clients within a correctional facility and the understanding of health care, disease prevention and health promotion practices by clients and non-health institutional personnel. The work requires participation in quality assurance activities.

Figure 3 - Text version

This is an organizational chart illustrating the reporting relationship for Health Care Officers NU-HOS which includes:

• Health Care Officer NU-HOS (6 positions)
• Clerk CR

The above positions are reporting to Chief Health Care NU-HOS who ultimately reports to the Deputy Warden AS.

Benchmark 4: Head Nurse

Level NU-HOS-04

Reporting to the Assistant Director of Nursing:

• On a 24-hour basis, plans and organizes short and long-term treatment in the unit. Identifies, with the health care team, goals for each client with respect to treatment and rehabilitation. Assures the continuous operation of the ward through the identification and acquisition of human resources, material and equipment. Assesses new products and equipment. Recommends the human and financial resource requirements for the unit and controls expenditures against the approved budget. Recommends modifications to policies and requisitions repairs. Assigns and schedules work for the ward clerk.
• Manages nursing staff activities. Guides team leaders with respect to their roles, hospital and nursing care policies and procedures, work methods, and infection control measures. Identifies staff training needs and cooperates in the implementation of a training program. Monitors the health care plans developed by team leaders. Participates in the selection process and evaluates staff. Solves difficult care-related problems such as the management of the acute phase of illness. Coordinates the exchange of information between clients, clients' significant others and caregivers. Manages the finances of administered clients. Ensures the collection and validity of patient classification information. Ensures staff in the unit respect standards of nursing practice, documentation and the professional code of ethics. Promotes a good quality of life for clients and staff.
• Reviews and authorizes treatment and activity schedules for the unit. Systematically reviews the application of health care techniques and safety measures and infection, accident, incident and fire prevention measures by professional and auxiliary employees. Advises staff on administrative and hospital and nursing care policies and procedures. Takes disciplinary action. Assesses the results of care provided by subordinates and evaluates the achievement of goals by qualitative and quantitative criteria. Represents nursing care services at multi-disciplinary team meetings. Ensures compliance with procedures governing narcotics and controlled drugs and the readiness of emergency equipment and appliances.
• Communicates information regarding administrative and patient care status to the health care team and to supervisors.

Figure 4 - Text version

This is an organizational chart illustrating the reporting relationship for Head Nurse NU-HOS which includes:

• Assistant Head Nurse NU-HOS (2 positions)
• Staff Nurse NU-HOS (5 positions)
• Nursing Assistant HS-PHS
• Ward Clerk CR
• Nursing Aide HS-PHS (3 positions)
• Nursing Orderly HS-PHS (12 positions)

The above positions are all reporting to Head Nurse NU-HOS who ultimately reports to the Assistant Director, Nursing NU-HOS.

Benchmark 5: In-Service Nurse Educator

Level NU-HOS-05

Reporting to the Assistant Director of Nursing, Education and Quality Assurance:

• Advises, as a clinical resource, nurses, and nursing administration on the planning, implementation and evaluation of nursing care programs. Evaluates difficult nursing care patients. Compiles unit-specific and hospital-wide data on patient classification levels and recommends staffing levels to management. Ensures accurate patient classification.
• Researches and communicates new developments in nursing theory and nursing practice. Modifies and recommends changes to nursing techniques.
• Performs training needs analysis. Develops, plans and implements training activities to meet the ongoing educational needs of individuals or groups of nursing staff. Develops training evaluation and validation tools to assess the effectiveness of training. Assesses educational resources at the community, provincial and national levels and utilizes appropriate resources. During orientation, evaluates new employees' performance on the unit and in the classroom. Coaches staff by demonstrating treatments, communication skills, group participation techniques, therapeutic approaches to patient care and other nursing functions.
• Plans, organizes, implements and evaluates nursing education programs, general orientation and specific unit-based orientation programs.
• Contributes to the development and implementation of the quality assurance program. Designs performance indicators and recommends priorities for the quality assurance program. Validates the effectiveness of evaluation instruments. Through quality assurance programs, analyzes nursing practice and makes recommendations to nursing administration.
• Designs research programs, implements research activities, tabulates data, formulates conclusions and presents results to nursing staff.
• Represents nursing education on a variety of committees such as, Bio-ethic, Infection Control and Quality Assurance. Prepares evaluation guides for the selection of new employees. Addresses professional and provincial organizations and educational institutions on psychogeriatric.

Figure 5 - Text version

This is an organizational chart illustrating the reporting relationship for In-Service Nurse Educators NU-HOS which includes:

• In-Service Nurse Educators NU-HOS (6 positions)
• Infection Control Nurse NU-HOS
• Nurse, Village Square NU-HOS
• Clerical Assistant CR

The above positions are all reporting to an Assistant Director of Nursing Education NU-HOS who ultimately reports to the Director of Nursing SM.

Benchmark 6: Coordinator

Level NU-HOS-05

Reporting to the Assistant Director of Nursing:

• Plans, coordinates, controls and assures the continuity of nursing care for the institution or part of the institution during evenings, nights, statutory holidays and weekends. Communicates to nursing staff and nursing administration all clinical and administrative information. Conducts nursing rounds, evaluates the quality of care and adopts corrective measures to respond to immediate needs. Guides, informs, orients and supports Assistant Head Nurses in their supervisory functions. Monitors the performance of Assistant Head Nurses and recommends evaluations to the Head Nurse. Participates on performance evaluation review, selection and classification committees. Advises staff on administrative policies and procedures. Interprets collective agreements and solves performance and disciplinary problems.
• Investigates client, family and employee complaints. Acts as patient advocate. Solves more serious clinical and administrative problems, such as emergency hospital admissions. Fosters the establishment and maintenance of a good quality of life for clients and staff.
• Ensures materials are provided to shifts. Liaises with pharmacy, laboratory, police, health agencies and other hospitals. Ensures the availability of a sufficient number of staff to meet operational needs. Controls the utilization of overtime. Trains staff in the utilization of materials and recommends the acquisition of supplies and equipment.
• Contributes to the design and implementation of the quality assurance program.
• Identifies education needs and coordinates schedules to allow for staff participation and use of materials and resources for training. Orients and trains staff.
• Attends management and committee meetings. Proposes solutions to clinical and administrative problems and plans interventions and strategies to meet unit and sector objectives. Reviews literature, attends conferences, and communicates information gathered.
• Investigates and reports incidents involving staff, clients and visitors. Ensures rules and regulations for accident and fire prevention are respected.
• Controls the night pharmacy. Assesses and evaluates staff or visitor emergencies and assists the duty physician in clinics or emergencies.

Figure 6 - Text version

This is an organizational chart illustrating the reporting relationship for Coordinators NU-HOS which includes:

• Head Nurse NU-HOS (12 positions)
• Coordinator NU-HOS (6 positions)
• Clerical Assistant CR

The above positions are all reporting to Assistant Director of Nursing NU-HOS (4 positions) who ultimately report to the Director of Nursing SM.

The following positions are reporting to the Head Nurse NU HOS position; however those positions are reporting to the Coordinator during evenings, nights, statutory holidays and weekend:

• Assistant Head Nurse NU-HOS (24 positions)
• Staff Nurse NU-HOS (36 positions)
• Nursing Assistant HS-PHS (8 positions)
• Ward Clerk CR (6 positions)
• Nursing Aide HS-PHS (36 positions)
• Nursing Orderly HS-PHS (140 positions)

Benchmark 7: Manager, Health Care

Level NU-HOS-05

Reporting to the Deputy Warden:

• Directs health care operations within the correctional facility. Trains, supervises and evaluates Health Care staff. Assesses effectiveness of nursing services and implements quality improvement programs.
• Plans and coordinates orientation, in-service education and continuing education programs. Coordinates schedules to allow for staff participation and use of materials and resources for training.
• Develops and implements emergency and routine care programs. Contributes to the development of standing Health Care Clinic Orders and procedures and ensures staff compliance. Develops institutional nursing service policies and standards. Develops administrative standing orders and emergency plans in accordance with Commissioner's Directives and Institutional Standing Orders. Recommends improvements to the reporting system. Ensures compliance with standards of nursing practice and documentation.
• Supervises or performs diagnostic laboratory tests. Schedules work. Orders, stocks and controls all medication and supplies.
• Recommends the Institutional Health Care Centre budget for human, financial and material resources. Controls expenditures and forecasts future needs. Analyzes space and program needs and makes recommendations for the use of existing facilities, expansions and new buildings. Encourages and develops effective relationships with clients, institutional personnel, community agencies and organizations serving the Health Care Centre.
• Conducts institutional inquiries. Investigates and responds to staff and offenders' complaints or grievances. Participates in selection committees. Represents Health Care on institutional and interdivisional committees.
• Develops community consulting resources such as medical and educational specialists. Negotiates the terms of contracts for medical and health care services. Procures diagnostic and radiology services.
• Liaises with the regional psychiatric/treatment centre admission unit and participates on a variety of committees such as the users committee for the regional psychiatric centre.
• Addresses service clubs, professional organizations, after care agencies and hospitals about Health Care Centre programs.

Figure 7 - Text version

This is an organizational chart illustrating the reporting relationship for Chief Health Care NU-HOS which includes:

• Health Care Officer NU-HOS (7 positions)
• Clerk CR

The above positions are reporting to the Chief, Health Care NU-HOS who ultimately reports to the Deputy Warden AS who reports to the Warden EX.

Benchmark 8: Assistant Director of Nursing

Level NU-HOS-06

Reporting to the Director of Nursing:

• Plans, directs and controls nursing care on a 24-hour basis for a sector of the hospital. Establishes nursing objectives and goals in accordance with the philosophy of the nursing directorate. Assesses and recommends nursing programs. Ensures that nursing activities, techniques and procedures meet accreditation requirements. Contributes to the development and establishment of standards for nursing care.
• Plans and implements the quality assurance program in the sector. Evaluates quality and continuity of nursing care. Cooperates with other department heads to provide a multi-disciplinary approach to care and treatment.
• Investigates, analyzes and documents incidents and complaints received from clients, clients' families or others and recommends solutions.
• Facilitates communication between all staff in the nursing directorate. Ensures effective implementation of the patient classification system. Recommends staffing levels in accordance with unit patient classification profiles.
• Plans and controls the human, financial and material resources in the sector. Forecasts and recommends short and long-term personnel, material and financial requirements. Recommends the organizational structure, identifies staffing needs, and recruits personnel. Coordinates the preparation of annual and multi-year budgets and variance reports.
• Ensures development and revision of operational and administrative policy manuals.
• Verifies and authorizes work schedules and requests for special leave. Ensures uniform interpretation and application of collective agreements and personnel policies and procedures.
• Identifies training needs and ensures staff participation in in-service and orientation programs. Meets regularly with staff and promotes a multi-disciplinary approach to health care. Discusses treatment results with the multi-disciplinary team and suggests alternative or corrective actions.
• Assesses information, data and consumer test reports relating to nursing equipment and furniture and recommends purchases as appropriate.
• Represents the Directorate of Nursing on committees such as infection control, medical records, and medico-nursing liaison. Chairs nursing committees such as medication incidents, health and safety and pharmaco-nursing. Chairs the sector Head Nurse Committee. Liaises with other professional disciplines to maintain continuity of care and integration of nursing services with other hospital services.
• Solves complex clinical and administrative problems, for example, client placement or movement between departments, institutions or the community. Researches specific issues and makes recommendations to improve performance of nursing programs. Works cooperatively with the In-Service Nurse Educators to develop and implement education and quality assurance programs and to identify and solve clinical nursing care problems.
• Monitors development of nursing policies and procedures. Ensures such policies respect federal and provincial legislation on health matters.
• Supervises a sector of Nursing services composed of 9 to 10 departments over 4 to 5 floors composed of approximately 200 employees in the Nursing and Hospital Services groups. Establishes work priorities and performance evaluation criteria. Monitors sector personnel management practices including performance evaluation, training and disciplinary action. Prepares performance appraisals for immediate subordinates.
• Researches new nursing trends and developments in administration, education and clinical practice. Serves as a resource for training programs. Addresses professional organizations, other health care agencies and educational institutions on programs and issues.

Figure 8 - Text version

This is an organizational chart illustrating the reporting relationship for Assistant Director of Nursing NU-HOS which includes:

• Chef, Recreation Services GT
• Assistant Director of Nursing, Education & Quality Assurance NU-HOS
• Assistant Director of Nursing NU-HOS (4 positions)
• Clerical Assistant CR

The above positions are all reporting to the Director of Nursing SM who ultimately reports to the Executive Director EX.

The following positions are reporting to the Assistant Director of Nursing NU HOS:

• Head Nurse NU-HOS (12 positions)
• Coordinator NU-HOS (6 positions)

The following positions are reporting to the Head Nurse NU HOS position; however those positions are reporting to the Coordinator during evenings, nights, statutory holidays and weekend:

• Staff Nurse NU-HOS (36 positions)
• Assistant Head Nurse NU-HOS (24 positions)
• Nursing Assistant HS-PHS (8 positions)
• Ward Clerk CR (6 positions)
• Nursing Aide HS-PHS (36 positions)
• Nursing Orderly HS-PHS (140 positions)

Benchmark 9: Community Health Nurse

Level NU-CHIN-03

Reporting to the Nurse-In-Charge, Health Centre:

• Organizes, implements and manages a comprehensive community health nursing program for residents of the Peigan Aboriginal community. Provides pre- and post-natal care. Teaches pre-natal classes, visits homes and makes referrals. Conducts child health clinics. Immunizes children and counsels parents of newborn infants and pre-schoolers.
• Works cooperatively with teachers and acts as a resource to school health program. Interprets program objectives for teachers and discusses health problems. Conducts physical assessments of pupils and makes referrals. Maintains immunization status of school children. Follows up on children's health problems with their caregivers.
• Conducts clinics and home visits to follow up clients with communicable diseases and their contacts.
• Teaches health education designed to meet the needs of the community. Provides counselling to individuals and groups.
• In emergency situations, manages the treatment of clients in the absence of a physician. Makes primary diagnoses, institutes first aid measures and arranges referral and transportation to the nearest medical facility.
• Develops and implements health education programs directed to individuals and groups in the community based on their aspirations and needs. Monitors clients with chronic diseases. Maintains a register for these clients, provides health clinics or home visits and dispenses medication to meet their needs.
• Plans and implements joint health-related projects with the province, other departments and voluntary agencies. Supports and encourages community initiatives and endeavours leading to their assumption of responsibility for health care.
• Assesses the health needs of the community and, in concert with representatives of other disciplines and community leaders, determines priorities for health programs. Reviews community statistical data on morbidity and mortality. Contributes to the evaluation of the effectiveness of the community health nursing programs.
• Arranges for Zone Staff and medical specialists' visits to the centre. Maintains nursing documentation. Identifies the need for supplies and equipment. Assigns work to subordinate staff and advises community health representatives on community health practices.

Figure 9 - Text version

This is an organizational chart illustrating the reporting relationship for Community Health Nurse NU-CHN which includes:

• Community Health Nurse NU-CHN (3 positions)
• Clerk CR
• Community Health Representatives HS (2 positions)
• Janitor GS
• Housecleaner GS

The above positions are all reporting to the Nurse in Charge NU-CHN who ultimately reports to the Zone Nursing Officer NU-CHN.

Benchmark 10: Occupational Health Nurse

Level NU-CHN-03

Reporting to the Occupational Health Nurse Supervisor:

• Provides occupational health nursing services to federal government employees. Assesses health service needs of employees and client departments. Plans and organizes services and develops programs within federal government's guidelines to meet the assessed needs of clients. Ensures the coordination of activities and the exchange of information with community agencies and with client departments.
• Establishes a confidential information and retrieval system within the health unit. Maintains legally acceptable health records and reports. Analyzes information and prepares statistical and other reports. Follows trends and developments reported in the literature for a variety of medical, nursing and occupational health subjects. Attends conferences and in-service education programs. Manages the health unit and its satellites. Ensures equipment is operational. Requisitions supplies, medications and educational materials designated for clients. Ensures the maintenance of standards of asepsis and cleanliness. Maintains the confidentiality of records and the security of the unit.
• Develops a professional relationship with employee organizations, and maintains a position of neutrality in matters of conflict with management.
• Liaises with management and obtains their cooperation in the implementation of various programs, such as occupational health evaluations, physical evaluation program, health hazard appraisal, physical fitness, hypertension and health education. Addresses employee and management groups on employee health services and special programs. Teaches employees how to maintain their own optimum level of health. Arranges displays of health promotion material. Writes articles for newsletters and other publications.
• Identifies health problems and possible causes, work-related and other. Assesses the need for special investigations, a full clinical history and partial appraisal of employees and performs or arranges for special investigations such as pulmonary function tests, electrocardiogram, audiogram, or blood tests. Interprets test results to employees and makes referrals. Performs occupational health evaluations on employees at high risk.
• Performs nursing treatment and provides medication to alleviate minor illnesses in the workplace. Assesses injuries and initiates emergency or other nursing treatments. Arranges for the transportation of ill or injured employees in accordance with the employing department's procedure. Provides treatment for chronic illnesses as ordered by family physicians, such as giving injections, monitoring blood pressure, and dressing changes.
• Provides confidential referral service to employees with specific needs (Employee Assistance Program). Counsels employees.
• Identifies and interprets limitations imposed by a disabling condition and advises the employee and management on adaptation to work requirements including work/rest routines post-illness or injury.
• Contributes to orientation, staff development and student field work activities. Presents seminars to nurses. Participates in inter-agency working committees for the development of educational/promotional tools for use in the occupational setting.
• Provides surveillance of environmental factors affecting health and safety of employees. Visits work locations to identify health hazards. Consults Environmental Health Officers and physicians about potentially hazardous conditions. Advises management and safety personnel on specific remedial action to be taken about specific hazards in the work environment. Demonstrates and interprets measures for the prevention of work-related accidents and illnesses. Ensures standard procedures are in place for medical emergency transport. Recommends the client department initiate special investigations related to noise, toxicity, radioactivity, light and heat levels. Establishes individual risk records for employees. Acts as a member of safety and emergency committees. Contributes to the development and implementation of work-related safety and educational programs. Documents and reports findings of environmental surveillance activities.

Figure 10 - Text version

This is an organizational chart illustrating the reporting relationship for 24 Occupational Health Nurse NU-CHN positions which report to the Occupational Health Nurse, Coordinator NU-CHN (8 positions) who ultimately report to the Senior Occupational Health Nurse NU-CHN

Benchmark 11: Nurse-in-Charge

Level NU-CHN-04

Reporting to the Zone Nursing Officer:

• Plans, organizes, directs and evaluates a primary health care service for the community. Assesses health indicators, determines program needs and organizes treatment clinic and satellite visits. Establishes an on-call schedule for station staff to provide 24-hour emergency nursing services.
• Takes history, determines mental status, performs a physical assessment for differential diagnosis considering the following body systems: skin; head and neck; respiratory; cardiovascular; peripheral vascular-veins, arteries-lymph; reproductive; upper and lower gastrointestinal; musculoskeletal; nervous and genitourinary.
• Initiates drug therapy as directed by medical standing orders, consultation or guidelines. Counsels, consults and refers clients.
• Provides pre- and post-natal care. Teaches pre-natal classes, visits homes and makes referrals. Conducts child health clinics. Immunizes children and counsels parents of newborn infants and pre-schoolers.
• Recognizes and manages common health problems which may be treated at the outpost and temporarily manages clients with more serious illnesses requiring referral to hospital, including the following: common medical disorders affecting adults; common pediatric problems requiring an understanding of normal growth and development of a child; common obstetrical conditions requiring an understanding of physical and emotional care required by the normal obstetrical client and infant through the maternity cycle; common genitourinary problems; acute emergency problems requiring medical and surgical intervention, such as lacerations, varying degrees of injuries, wounds, fractures and abrasions. Provides emergency treatment and assessment for referral of clients with orthopedic problems. Provides temporary management and referral for treatment of clients with psychiatric problems.
• Plans, organizes, directs and evaluates a comprehensive community health nursing program for residents of an isolated community. Assesses physical, social, emotional and environmental factors influencing the health of individuals and the community and adjusts program content and delivery. Allocates work to nurses, Community Health Representatives and support staff on the health team. Analyzes performance indicators and adjusts work plans. Identifies areas for improvement of program delivery. Introduces improved work methods.
• Identifies communicable diseases and performs contact tracing and follow-up. Instructs clients on prevention and treatment of diseases and implements an immunization schedule.
• Maintains a register of clients with high-risk problems and ensures their monitoring and care. Organizes special screening clinics to identify chronic conditions such as diabetes and hypertension.
• Organizes special health education classes. Works cooperatively with teachers and acts as a resource in the school health program. Provides advice to parents, caregivers and teachers on health appraisal, screening and immunization.
• Directs staff in the development and implementation of work plans. Selects, trains, and evaluates staff. Acts as a specified officer in the grievance process. Assists community administrators in the selection of health-related personnel such as Community Health Representatives. Develops and implements specific in-service education programs for staff. Trains, orients and provides functional supervision to community health representatives and monitors their performance. Informs the Zone Nursing Officer of problems. Guides and provides field experience for nursing students.
• Organizes and directs the nursing station administration. Ensures the completion and maintenance of patient and administrative records. Ensures clinic equipment, vehicles and facilities are maintained. Controls the inventory of supplies for the clinic and the station. Authorizes medical transportation of patients to hospitals. Facilitates visits of dental, optometric and other specialists who independently provide service to communities. Reports on nursing activities.
• Resolves complaints and concerns received from the client group. Refers such complaints to the Zone Nursing Officer when their nature exceeds the local level.
• Works cooperatively with leaders of client organizations, community organizations, local health committees, service agencies and other levels of government.

Figure 11 - Text version

This is an organizational chart illustrating the reporting relationship for Nurse-in Charge NU-CHN which includes:

• Nurse-in Charge NU-CHN
• Zone Community Health Representative Advisor HS-PHS
• Clerk CR

The above positions are all reporting to the Zone Nursing Officer, NU-CHN who ultimately reports to the Zone Director, South Zone PM.

The following positions are reporting to the Nurse-in Charge position:

• Community Health Nurse NU-CHN (2 positions)
• Clerk CR
• Janitor GS
• Housemaid GS
• Community Health Representatives HS (2 positions)

Benchmark 12: Regional Nurse Educator

Level NU-CHN-06

Reporting to the Regional Nursing Officer:

• Plans, develops and implements a primary care skills program and community health in-service education programs. Formulates the philosophy, objectives and guidelines of the programs. Develops the curriculum design and program content. Develops and plans community health and primary care educational activities (theoretical and experiential). Determines the general and specific learning needs of program participants. Designs techniques and methods for program implementation.
• Plans, implements and evaluates a general and a cultural orientation program for new nurses. Identifies the orientation needs of new nurses and the human, financial and material resources necessary to accomplish their orientation. Develops and manages the primary care skills education program budget. Controls person-years allocated to the program. Recruits and supervises trainees for the primary care skills program. Plans education program activities and negotiates regional, zone and field participation. Monitors, reviews and evaluates their participation in education programs and recommends strategies for improvement. Organizes field experience activities in clinical settings in hospitals, nursing stations and health centres. Ensures students' cultural orientation through meetings with representatives of Aboriginal peoples. Evaluates the effect of the orientation program through field visits and identifies and implements modifications required.
• Identifies, develops and modifies resources required for the professional nursing education and training programs. Identifies, through discussions with representatives of university schools of nursing and professional organizations, resources appropriate to the educational needs of staff. Selects audio-visual material. Modifies existing materials and develops new materials such as video-tapes, slides and tapes for distribution to regional nursing staff. Advises on innovations in community health and primary care nursing. Researches professional journals, manuals, standards and evaluation methods. Ensures the maintenance of a data bank of educational programs and resources. Evaluates costs for optimal resource utilization.
• Evaluates the Regional Education Programs and delivers education and training sessions. Organizes the contribution of specialists, i.e. cultural orientation, primary care, administration. Defines parameters for educational content to resource persons participating in regional education programs.
• Develops criteria to evaluate the acquisition of knowledge and skills. Adapts, in cooperation with headquarters, the education processes and program content to meet field requirements. Assesses the performance and competency of nurses participating in the education program. Evaluates the programs' overall effectiveness. Advises nursing staff on their professional development. Advises the Regional Nursing Officer and Supervisors, on the performance and potential of nursing staff.
• Participates in research projects, professional meetings and committees. Addresses professional and international organizations, conferences and educational institutions on primary health care. Establishes program credibility and acceptance by the Aboriginal communities and organizations.

Figure 12 - Text version

This is an organizational chart illustrating the reporting relationship for Regional Nurse Educator NU-CHN which includes:

• Regional Nurse Educator NU-CHN
• Clerk CR
• Assistant Regional Nursing Officer NU-CHN

The above positions are all reporting to the Regional Nursing Officer NU-CHN who ultimately reports to the Assistant Regional Director Community, Health Programs SM.

Three Primary Care Skills Program Trainees NU-CHN positions are reporting to the Regional Nurse Educator NU-CHN position.
The Regional Nurse Educator NU-CHN provides specialist advice to the following positions:

• Zone Nursing Officer NU-CHN (5 positions)
• Director of Nursing NU-HOS

Benchmark 13: Zone Nursing Officer

Level NU-CHIN-06

Reporting to the Zone Director:

• Directs and advises Nurses-in-Charge of field units in specified locations. Develops and introduces improved nursing techniques, intra-unit organization and work flow systems. Standardizes record procedures reducing duplication and improving patient and administration records. Regularly visits field units. Discusses and observes field programs and assesses problems, workload, and organization of work. Coordinates accommodation and living arrangements for field personnel in isolated posts with limited personal space. Facilitates problem-solving, communication and effective relationships. Recommends methods of handling specific nursing problems. Resolves differences of opinion between staff and the client organization. Investigates untoward incidents in isolated communities involving staff or community members where frustrations sometimes result in high staff turnover and in serious disruptions to program delivery.
• Advises staff on administrative and clinical issues and departmental policies. Adjusts work plans to changing priorities. Plans and controls staffing patterns and absences to ensure operational requirements are met and service standards maintained. Establishes local field unit policies. Reviews reports from field units concerning living or working conditions, buildings and transportation. As one of three zone nursing officers recommends improvements or solutions to problems to the Zone Director. Conducts client and administrative records and nursing audits. Approves requisitions for supplies and equipment.
• Evaluates the need for field nurses and auxiliary staff and modifies staff complements to meet emergencies, changing situations or to optimize the use of the staff's knowledge, skill and abilities. Writes job descriptions, submits for classification and initiates staffing action. On behalf of the Zone Director, negotiates and monitors contracts for services with First Nations and external agencies. Arranges for the transfer of nurses within the Zone and recommends transfers outside the Zone.
• Recruits staff and identifies training needs. Appraises staff performance and solves performance and disciplinary problems. Represents the department in the grievance process.
• Plans, implements and evaluates orientation and in-service development for nurses and auxiliary staff. Ensures the provision of orientation training concerning health and nursing standards and procedures including personal safety, northern living and client group information. Explains the philosophy, objectives and principles of prevention and treatment programs. Demonstrates and teaches nursing methods, techniques and procedures. Supervises the field unit assignments of nurses enrolled in in-service Community Health Nurse Program. Develops and contributes to the in-service program for Community Health Representatives.
• Contributes to the Zone's operational plan and review and budget process incorporating nursing requirements in the planning of future health services. Coordinates the implementation and review of work plans. Reviews monthly variance reports and recommends corrective actions. Reflects changes in the multi-year forecast and the final main estimates in budget and work plan documents. Reviews current programs, recommends program changes and the introduction of new programs.
• Analyzes health-related statistical data to identify health needs and program priorities. Analyzes nursing activity reports to determine program delivery levels. Evaluates nursing programs.
• Works cooperatively with leaders of client organizations and representatives of adult education, Provincial Departments of Health and Social Development, Aboriginal Affairs, schools, and others. Encourages community-initiated projects and health committee formation.
• Consults with leaders of client organizations on management and organization of the health facility. Visits facilities and assists nurses to prepare work plans and establish priorities. Contributes to the definition of new programs, to the evaluation of the work required and the definition of the nurses' role. Recommends changes necessary to improve nursing service standards. Functionally supervises nurses employed by the leaders of client organizations.
• Participates in research projects, professional meetings, management and interdisciplinary committees. Promotes departmental programs and policies to clients. Addresses educational institutions and professional meetings on nursing programs.

Figure 13 - Text version

This is an organizational chart illustrating the reporting relationship for Zone Nursing Officers NU-CHN which includes:

• Zone Nursing Officers NU-CHN (3 positions)
• Hospital Administrator AS
• Secretary ST-SCY
• Zone Health Educator ED
• Assistant Zone Director AS

The above positions are all reporting to the Zone Director, South Zone PM who ultimately reports to the Assistant Regional Director MD-MOF.

The following positions report to the Zone Nursing Officers NU-CHN:

• Zone Community Health Representative Advisor HS
• Zone Nursing Administrative Clerk CR (2 positions)
• Nurse-in-charge NU-CHN (9 positions)

Benchmark 14: Regional Nursing Officer

Level NU-CHN-07

Reporting to the Assistant Regional Director:

• Ensures the availability and ease of access for client groups to quality nursing care and promotes a high standard of nursing practice in Ontario Region, in two hospitals, transferred programs and direct local health services, involving primary care and treatment programs.
• Works cooperatively with the Programs' Medical Office to ensure the currency and relevancy of program guidelines. Communicates program guidelines to regional nursing staff. Incorporates Standards of Practice from The College of Nurses of Ontario and The Canadian Nurses Association into regional nursing standards. Reviews Hospital Accreditation Standards and Accreditation Committee recommendations. Encourages the implementation of changes in hospitals to improve their Quality Assurance Programs. Advises Zone Nursing Officers and Directors of Nursing, on the development and updating of policy and procedure manuals.
• Conducts reviews of nursing records and implements changes to ensure records are complete, relevant, legally viable and appropriate. Implements a system of nursing audit for all nursing programs. Audits the nursing care quality and develops proposals for corrective action and improvements.
• Develops and implements a regional nursing program reporting system facilitating the production and utilization of management and operational information for program development, planning and for adaptation to technical electronic data.
• Ensures the presentation of the orientation program to Zone Nursing Officers and other new senior nursing staff.
• Visits the field and encourages the planning and evaluation of nursing programs, practices and projects in the Region. Functionally supervises Zone Nursing Officers and advises on the resolution of problems, such as safety and security infractions affecting nursing personnel.
• Facilitates the transfer of health programs to Aboriginal control. Safeguards high professional nursing standards during and after the transition from direct providers to facilitators. Promotes the Branch transfer philosophy to nursing staff. Communicates with Aboriginal organizations and First Nation administrations. Explains the scope of community health programs and nursing standards, promotes the principles of community organization and evaluates the receptivity of communities to the transfer of health programs. Identifies and evaluates barriers to the implementation of transfers and; develops counter-active responses.
• Develops, with the Regional Programs Committee, health program strategies, programs and techniques to meet the needs of transferred populations at special risk.
• Monitors contribution agreements to verify compliance to policies and standards. Recommends approval of agreements or recommends changes to improve service quality. Recommends conditions of employment for First Nation-employed nurses including pay, benefits, hours of work, legal liability and coverage for inclusion in contribution agreements.
• Directs the preparation of regional planning and budgeting documents. Develops strategies and methods for the cost-effective implementation of Branch and regional policies on nursing. Guides planning and ensures the reflection of Branch priorities in the nursing programmes Zone operational and work plans.
• Develops and controls the budget for the regional nursing operation. Advises the Regional Director on new and emerging issues, trends and development pertaining to the nursing aspects of health care.
• Works cooperatively with the Branch Nursing Advisor, Human Resources to deliver the annual national recruitment program, to update recruitment sources, and to deliver or arrange for the delivery of recruitment presentations at university schools of nursing. Coordinates the attendance of Zone staff at Nursing Job Fairs, Career Fairs and other recruitment activities.
• Advises on contracts between the department and nursing employment agencies. Participates in the selection process. Advises on job descriptions, classification, the organization of work and the interpretation of the collective agreement. Contributes to the selection process and develops career strategies for senior regional nursing management. Recruits, trains and advises subordinates. Evaluates staff performance and solves performance and disciplinary problems. Manages the computerized nursing inventory information system in the region.
• Negotiates the nursing component of university contacts providing for example field experience for university nursing students, educational resources and consultation services to regional staff. Coordinates arrangements for nursing experience in the region. Reviews the utilization and effectiveness of these university contracts. Monitors contract performance, determines the cause of variances and recommends corrective measures to the contractor.
• Assesses the training needs of primary care nurses and advises the Regional Director. Directs the scheduling of training for field nurses in programs designed to improve competency. Directs the regions participation in the annual education program including the receipt of applications and the development of the submission.
• Works cooperatively with representatives of the College of Nurses of Ontario, the Registered Nurses Association of Ontario, the Canadian Nurses Association and senior departmental officers to further the achievement of nursing programs.
• Addresses educational institutions, professional organizations and conferences on nursing programs. Participates in committees, prepares ministerial correspondence and ministers briefing notes.

Responsibility for Management and Management Advisory Services

Degree 7

Evaluates nursing service delivery, develops standards and advises the Regional Director on policies for the delivery of community health and treatment services. Gives direction to Regional Nurse Educators and functional direction to Zone Nursing Officers and Directors of Nursing in hospitals. Advises on the organization and resource requirements for the region and establishes, implements and controls the Regional Nursing Office budget. Advises headquarters on the need for improved nursing practices and revises, evaluates and recommends modifications to nursing standards, techniques and guidelines.

Impact

Degree 7

Activities affect a wide variety of community health and treatment services provided to individuals, groups and communities in the region. Decisions on changes to the regional health programs to meet client needs affect quality of health care. Decisions also affect regional policies and influence the policies of other regional disciplines. Recommendations affect the development of national policies. Advice, direction and support provided to Aboriginal organizations impact on their assumption of control for health care services. Cooperative partnering with representatives of provincial or territorial professional registering organizations results in the resolution of nursing practice issues. Liaison with education institutions influences the development of curriculum and facilitates recruitment, continuing education and field experience.

Figure 14 - Text version

This is an organizational chart illustrating the reporting relationship for Regional Nursing Officer NU-CHN which includes:

• Regional Dental Officer DE
• Regional Nursing Officer NU-CHN
• Program Medical Officer MD-MOF
• Secretary ST-SCY (2 positions)
• Chief, Community Health Planning & Development PM

The above positions are all reporting to the Assistant Regional Director SM who ultimately reports to the Regional Director EX.

The following positions report to the Regional Dental Officer DE:

• Assistant Dental Officer DE
• Dental Hygienist EG
• Claims Clerk CR

The following positions report to the Regional Nursing Officer NU-CHN:

• Regional Nurse Educator NU-CHN
• Assistant Regional Nursing Officer NU-CHN
• Clerk CR

The Regional Nursing Officer NU-CHN also provides advice to the following two positions:

• Zone Nursing Officer NU-CHN (6 positions)
• Director of Nursing NU-HOS

The following positions report to the Chief, Community Health Planning & Development PM:

• Regional Consultant Community Health Services PM
• Regional Advisor Indian/Inuit Health Careers & Continuing Education ED
• Health Assistant (Term)

Benchmark 15: Nursing Consultant Transfer Policy and Practices

Level NU-CHN-08

Reporting to the Director Nursing Services:

• Advises on the development, implementation and evaluation of current health care delivery services for Aboriginal and Northern client groups relative to assuming health services in a community controlled environment. Develops specific nursing policy, standards, guidelines and evaluation methods for the provision of clinical and public health services in relation to transfer.
• Assesses the impact of new developments in the client transfer initiatives that impact on nursing services. Makes recommendations through the development of guidelines, standards and strategies to ensure nursing operations in the health care delivery system are addressed in the formulation of transfer policy and in the development of corresponding programs.
• Advises Regional Nursing Officers on the interpretation of national transfer initiatives and policies as well as providing guidance in the development of Region specific policies and manuals.
• Reviews proposed transfer policies to ensure feasibility and ascertain impact on long-term resource requirements. Examines the present role of nurses in Aboriginal Northern Health and recommends changes to more effectively utilize nursing resources.
• Provides guidance to First Nations on key aspects of the provincial health care system and their implication for Aboriginal Health authorities.
• Identifies and provides guidance to First Nations on the need for compliance with provincial health care standards and evaluates the impact of these standards in relation to diseconomies of scale and the resultant impact on resourcing.
• Works cooperatively with provincial nursing associations to develop and adapt nursing practices and standards to ensure that the duties identified as being part of the "expanded role" are incorporated into the parameters of practice at the provincial level, the direct effect of which will allow for liability/malpractice coverage for Medical Services Branch nurses.
• Identifies areas requiring transfer research and coordinates and participates in research projects of national scope. Researches approaches to health care delivery existing in developing countries, determines the appropriateness of concepts and their potential for application in Aboriginal and Northern Health. Analyzes and evaluates health strategies and recommends improvements to existing methodologies.
• Consults with senior federal and provincial nurses at the Annual Federal/Provincial Nursing Consultants Meeting. Explores trends and developments in hospital and community health nursing services in Canada impacting on transfer initiatives.
• Exchanges federal experience in the transfer activities of health care delivery, nursing care policy and medical services in Aboriginal Northern Health with senior provincial health officials. Facilitates the formulation, of nursing care policy in community health and hospital nursing in cooperation with representatives of other jurisdictions.
• Facilitates the definition of the roles of provincial governments and Aboriginal communities following the transfer of responsibility for health services to the Aboriginal population.
• Develops and delivers workshops for zone and regional personnel and Aboriginal communities on community development and motivation.
• Investigates and assesses problems involving nurses or nursing service issues pre and post transfer and develops recommendations for solutions which maintain the delivery of health care.
• Advises on programs, priorities and objectives to reflect changing demands both in health-care requirements as well as the changing roles played by the Aboriginal and Northern populations in the definition, planning and ultimate control of health services. Fosters the development of effective primary health care delivery systems in Canada.
• Participates in committees with officials of national offices of health organizations and international agencies and other government departments to exchange information, identify current trends in nursing, health programs and health care delivery systems and to develop input to the health policies.
• Liaises with government departments at all levels, with care giving organizations, and with groups representative of the programs clients such as the Assembly of First Nations, Committees for Original People Entitlement to discuss health services and other health relates issues.
• Addresses education institutions, professional organizations and conferences on transfer initiatives relative to Aboriginal and Northern Health. Advises departmental management on new trends and technologies affecting Aboriginal and Northern Health programs. Prepares ministerial briefings and correspondence relative to assuming health services in a community-controlled environment.
• Makes recommendations through the development of guidelines, standards and strategies to ensure nursing operations in health care delivery system operations are addressed in the formulation of transfer policies and in the development of corresponding programs.

Professional Complexity and Responsibility

Degree 8

The work requires the provision of advice to departmental senior management, to other government departments, to First Nations on health and delivery services for Aboriginal and Northern client groups related to the Transfer Program Policy. The work also requires identification of research requirements, development of research projects and translation of the latest innovations in health care in Aboriginal and Northern programs into modified policies enhancing the quality and delivery of service. Guidance is received on government policy and objectives from the line supervisor. Advice is given to the department, to other departments and to the government on development of national transfer policies and health care practices.

Responsibility for Management and Management Advisory Services

Degree 8

Evaluates programs, develops operating policy and proposes innovative approaches in health care delivery for Aboriginal and Northern transfer programs. Identifies trends and develops solutions to emerging problems. Advises on the organization of and human resource requirements for the transfer of health care delivery services. Provides functional direction to senior Aboriginal and Northern health nurses. Develops standards for the provision of clinical and public health services in relation to transfer for national implementation.

Impact

Degree 8

Activities affect the health care delivery services for Aboriginal and Northern client groups involved in transfer. Decisions affect national transfer programs and policies. Representation of the government in the international nursing forum influences the development of primary health care services at the international level. The design of evaluation methods and systems for national implementation affect the quality of programs. Decisions affect the transfer strategies of the government. Cooperative activities with agencies external to the department further the achievement of the department's objectives.

Figure 15 - Text version

This is an organizational chart illustrating the reporting relationship for Nursing Consultant Transfer Policy and Practices NU-CHN which includes:

• Nursing Consultant, Human Resource Planning & Career Development NU-CHN
• Nursing Consultant, Operating Policy & Program Development NU-CHN
• Nurse Educator NU-CHN
• Nursing Consultant, Research & Development NU-CHN
• Nursing Consultant Training & Education NU-CHN
• Nursing Consultant, Transfer Policy & Practices NU-CHN
• Secretary ST-SCY

The above positions are all reporting to the Director of Nursing, Indian & Northern Health SM who ultimately reports to the Director General, Indian & Northern Health Services MD-MOF.

The following positions report to the Nursing Consultant, Human Resource Planning & Career Development NU-CHN :

• Clerk CR
• DOPN Trainees (11 positions) (NU-CHN)

There are fifteen Regional Nursing Officers NU-CHN reporting to the Director of Nursing, Indian & Northern Health SM.